Registered Radiologist Assistant Skills Checklist

Requested by:

Requested by email:

Today's Date: * +

First Name: *

Last Name: *

Mobile Phone Number: *

Email Address: *

Confirm email: *

GENERAL SKILLS EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Advanced directives	123
National Patient Safety Goals/Core Measures	123
Awareness of HCAHPS	123
Accurate Patient Identification	123
Maintain Sterile Field	123
Demonstrates knowledge of anatomy	123
Use proper body mechanics	123
Use of transfer/lifting Devices	123
Infection Control	123
Universal Precautions	123
Follow Sterile and Aseptic technique	123
Isolation Precautions	123
Minimize fall risks	123
Crash Cart	123
Defibrillator	123
Care of patient in Restraints	123
Patient /Family education	123
Ensures HIPAA compliance	123

PREPARE FOR PATIENT EXAMINATION:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Review patient medical record/ history	123
Review abnormal or missing lab values (eGFR, Beta-hCG)	123
Assist Radiologist in Abdominal exam	123
Assist Radiologist in Thoracic exam	123
Assist Radiologist in musculoskeletal exam	123
Assist Radiologist with peripheral vascular exam	123
Assist Radiologist with neurological exam	123
Assist with breast and axillae exam	123
Oxygen delivery device	123
Pulse oximetry	123
Assist with urinary catheterization	123
Assist with venipuncture	123
Monitor IV lines	123
Participate in administration of moderate/conscious sedation as prescribed	123

VITAL SIGNS:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Obtain and assess manual blood pressure	123
Assess and administer oxygen therapy	123
Assess and monitor heart rate	123
Assess and monitor pain	123
Assess for anxiety	123

MEDICATION AND MONITORING:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Administer Contrast Agents as prescribed	123
Administer radiopharmaceuticals as prescribed	123
Monitor for side effects or complications of medications	123
Document Fluoroscopy time and radiation dose	123

GASTROINTESTINAL STUDIES:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Esophageal Study	123
Swallow function test	123
Upper GI study	123
Post-operative study(bariatric study, anastomosis check)	123
Small bowel study	123
Enema with barium, air, or water contrast	123
Nasogastric tube placement	123
Enteric tube evaluation and verification	123
T-Tube Cholangiogram	123

GENITOURINARY STUDIES:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Antegrade urography through existing catheter	123
Cystography (not voiding)	123
Retrograde urethrography	123
Voiding cystography/cystourethrography	123
Urinary diversion study (loopography)	123
Hysterosalpingography imaging	123
Hysterosalpingography- procedure and imaging	123

INVASIVE NONVASCULAR PROCEDURES WITH IMAGE GUIDANCE AND CONTRAST MEDIA AND NEEDLE OR CATHETER PLACEMENT:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Therapeutic bursa aspiration and or injection	123
Diagnostic joint aspiration	123
Therapeutic joint injection	123
Arthrography (radiography, CT and MR)	123
- Shoulder	123
- Elbow	123
- Wrist	123
- Hip	123
- Knee	123
- Ankle	123
Lumbar puncture without injection	123
Lumbar puncture for myelography or cisternography	123
Cervical imaging	123
Thoracic imaging	123
Lumbar myelography	123
Thoracentesis with or without catheter	123
Placement of catheter for pneumothorax	123
Paracentesis with or without catheter	123
Abscess, fistula, or sinus tract study	123
Percutaneous drainage with or without placement of catheter	123
Removal of percutaneous drainage catheter(tunneled or non-tunneled)	123
Change of percutaneous tube or drainage catheter	123
Injection of Sentinel node localization	123
Biopsy thyroid	123
Biopsy superficial lymph node	123
Biopsy liver (non-targeted)	123
Biopsy superficial soft tissue mass	123

INVASIVE VASCULAR PROCEDURES WITH IMAGE GUIDANCE INCLUDING CONTRAST MEDIA ADMINISTRATION AND NEEDLE CATHETER PLACEMENT:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Peripheral insertion of central venous catheter (PICC Placement)	123
Insertion of non-tunneled Central Venous Catheter	123
Central Venous catheter removal	123
Extremity Venography	123
Perform CT post-processing	123
Perform MR post-processing	123
Evaluate images for diagnostic quality	123
Review imaging procedures	123
Communicate observations to supervising radiologist	123

WORK SETTING:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Acute hospital	123
Large/regional teaching facility	123
Outpatient	123

CERTIFICATIONS/LICENSURE/REGISTRATIONS:

Rank each of the following sections on a scale of 1 to 2:
1) Yes
2) No *

BLS	12
ACLS	12
PALS	12
ARRT	12
ARRT (Vascular Interventional)	12
Fluoroscopy	12

AGE-SPECIFIC EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Newborn / neonate (birth-30 days)	123
Infant (31 days-1 year)	123
Toddler (ages 2-3 years)	123
Preschool (ages 4-5 years)	123
School age (ages 6-12 years)	123
Adolescent (ages 13-21 years)	123
Young adult (ages 22-39 years)	123
Adult (ages 40-64 years)	123
Older adult (ages 65-79 years)	123
Elderly (ages 80+ years)	123

Attestation

ATTESTATION: *

I certify that the information provide above accurately reflects my experience in each of the clinical areas identified within the past three years.

If you agree with the Attestation above, please electronically sign your name. *